The effectiveness of a brief intervention for illicit drugs linked to the alcohol smoking & substance involvement screening test (ASSIST) in Primary Health Care settings

First published: 10 May 2019 | Last updated: 20 May 2019

Aims: WHO Phase III ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) Project aimed at evaluating the effectiveness of ASSIST linked Brief Intervention (BI) for illicit drugs. ASSIST was developed by World Health Organisation (WHO) to screen for problem use of tobacco, alcohol, and illicit substances in generalist health care and can be linked to intervention.

Design: Randomized Controlled Trial

Setting: Primary care settings in Australia, Brazil, India and USA

Participants: Participants screened at Baseline using ASSIST, allocated to BI (for highest scoring substance on ASSIST) or waitlist control and assessed after 3 months using ASSIST.

Intervention: BI for illicit drugs

Measurements: Change in ASSIST Total and Specific Substance Involvement scores at baseline and 3 months analysed by Two-way repeated measures ANOVA.

Findings: Of all the participants screened 731 scored between 4 and 26 (moderate risk) for illicit drugs and were randomly allocated with 372 participants in the BI group (50.9%) and 359 (49.1%) in the Control group. There were 395 participants in the cannabis group, 247 in the stimulants group (92 cocaine; 155 ATS) and 89 in the opioids group. 628 (86%) participants were followed up. Follow-up scores were significantly lower scores for Total Illicit Substance Involvement (except the United States site) and for Cannabis, Stimulant and Opioids specific scores at all the sites.

Conclusions: ASSIST is cross culturally relevant screening instrument. There is reduction in illicit drug use associated with BI when used linked to ASSIST and it did not result in an increase in use of other substances.

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Dr Hem Raj Pal